Use It or Lose It – Make an Appointment Now
Maximizing Health Insurance Benefits Before They Expire
It’s that time of year when patients carrying health insurance have hit their “out-of-pocket” (OOP) maximum. At this time of year it’s possible to enjoy medical visits free of charge (co-pays waived). For most insurance plans this opportunity typically expires and resets on December 31st, so Hawthorn Healing Arts Center would like take this opportunity to encourage folks to use these benefits now.
As part of our ‘take responsibility of your health and personal empowerment’ way of thinking, and to avoid unexpected billing surprises, we encourage patients to have a solid understanding of their insurance plan including the various coverage details, deductible status, etc., before making an appointment.
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Did you know that all Health Insurance is required by law to provide you with FREE medical screenings every year with no copay or deductible? For Women (and Transgender Men), that actually means 2 exams per year:
- The Annual Women’s Health Exam (usually includes a pelvic exam, clinical breast exam, and possibly a Pap)
- An Annual Physical Exam
These are called “Annual” exams for a reason, and offer a “freebie” chance to check in with your practitioner.
But there are many screening tests, and how often should they be done?
A very good question, with a complicated answer, “it depends!” Which takes us back to the annual exam. This gives you and your practitioner time to discuss the variables involved (family history, past medical history, risk factors, lifestyle, etc.) and come up with a schedule. Let’s go over some of the tests, and look at the variables and timelines for each.
We encourage people to get yearly labwork/bloodwork. Some people may need more monitoring of certain conditions such as thyroid, diabetes, etc.
Mammogram: screening for Breast CA
Risk factors? Family History of Cancer, prior breast biopsy with pathology, early menses start as a child, late menopause, no pregnancies, late age of 1st pregnancy, HRT, no breastfeeding, increased age, increased weight, alcohol, smoking, dense breasts, high dose chest irradiation at 10-30yo.
- Age to start? Guidelines say offer at 40yo, recommend at 40-50yo.
- How often? Every 1-3 years (shared decision making, depending on risk factors)
- When to stop? 75yo or 10 yrs life expectancy
- Adverse events? False positives, anxiety, distress, discomfort, over Diagnosis, and Treatment, Radiation
- Alternatives? Thermography, US, MRI. Thermography is offered here at HHAC.
- Men can get Breast CA too! Clinical breast exam, Thermography & Mammogram are available for Men.
Pap/HPV: screening for Cervical CA.
Risk factors? Caused by HPV a STI. Sexual contact, # of partners, new partners. Other risk factors are Hx of Cervical CA, HIV, weakened immune system, exposure to DES. It is very common, and most people who are sexually active will get an HPV infection in their lifetime. HPV infection often causes no symptoms. Most HPV infections go away on their own. These short-term infections typically cause only mild (“low-grade”) changes in cervical cells. The cells go back to normal as the HPV infection clears. It usually takes 3–7 years for high-grade changes in cervical cells to become cancer. Cervical cancer screening may detect these changes before they become cancer.
Age to start? 21 yo or when sexually active after this age. Too many false positives when done earlier.
How often? aged 21–29 years should have a Pap test alone every 3 years. HPV testing is not recommended. Women aged 30–65 years should have a Pap test and an HPV test (co-testing) every 5 years (preferred). It also is acceptable to have a Pap test alone every 3 years.
When to stop? after age 65 years if
- you do not have a history of moderate or severe abnormal cervical cells or cervical cancer, and
- you have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past 5 years.
*If you have had a hysterectomy, you still may need screening. The decision is based on whether your cervix was removed, why the hysterectomy was needed, and whether you have a history of moderate or severe cervical cell changes or cervical cancer. Even if your cervix is removed at the time of hysterectomy, cervical cells can still be present at the top of the vagina. If you have a history of cervical cancer or cervical cell changes, you should continue to have screening for 20 years after the time of your surgery.
- Adverse events? False positives, anxiety, distress, discomfort, over Dx, over Tx.
- Alternatives? None.
- Vaccine? Available for HPV. Controversial. In my experience not very effective. I’ve seen many people get the vaccine and then go on to get HPV.
DEXA: screening for Osteoporosis
Risk factors? Risk factors for osteoporotic fractures include parental history of hip fracture, smoking, excess alcohol consumption, and low body weight. In addition, menopausal status in women is also an important consideration. For postmenopausal women younger than 65 years who have at least 1 risk factor, a reasonable approach to determine who should be screened with bone measurement testing is to use a clinical risk assessment tool, such as FRAX. Being Female, age, race, parental history of hip fracture, smoking, excessive alcohol consumption, and low body weight. In addition, menopausal status in women, lack of hormone exposure (amenorrhea, premature menopause)
- Age to start? Post menopause. Usually want to get a screening within the 1st few years of menopause. If menopause is early, check early. For women with a history of no menses, low body weight, disordered eating, may be done sooner.
- How often? Not more often than every 2 years. Depends on risk factors. Use FRAX score.
- When to stop? 75 yo, use FRAX score for guidance.
- Adverse events? radiation
- Alternatives? Other screening tests include peripheral DXA and quantitative ultrasound. NTX urine or blood.
- Men can get Osteoporosis too! DEXA’s are available for Men.
Colonoscopy: screening for Colon CA
- Risk factors? PMHx of Colon cancer, polyps, Fhx Colon CA, AK natives, African American
- Age to start? 45 yo recommended, 50 yo strongly recommended
- How often? Fecal Occult Blood yearly, Colonoscopy every 10 yrs * depending on risk factors.
- When to stop? 75Yo, 75-85 depending on risk factors, etc.
- Adverse events? As with any ”surgery” type procedure, there are risks, such as perforation.
- Alternatives? FOB, sigmoidoscopy, virtual colonoscopy, Cologuard DNA test.
It is important to see your physician annually to determine what tests/screenings are right for you so that you can be informed about your own health and empowered to make positive healthcare decisions.
To make an appointment call 541-330-0334 or click the button below, fill out the form and the appointment desk will get right back to you.